Progesterone dominance

[CyndiLou]

I am 54, post menopause 6 years. Currently take Estrace 1mg oral and 200 mg prometrium.

I just started the oral type estrogen 3 weeks ago when we determined I have not been absorbing estradiol in patch form after trying to improve symptoms over the past year. Despite patch increases my levels were not going above 25 pg/mL. Ongoing symptoms were cognitive, energy/stamina and depression related. I feel like I am now getting some estrogen via the oral route as I feel better most days. BUT I continue to experience random days of extreme mood swings , almost constant 'PMS' feeling - like back in the days of having PMDD. I now suspect the 200mg Prometrium is the culprit to my ongoing depression and mood swings. Considering the past year I was taking 200 mg progesterone with little to zero estrogen actually getting in- is it possible to be too dominant with progesterone and having these symptoms? My last lab for progesterone was in August 2021 and it was 1.3 ng/mL after being on 100mgs progesterone for 4 months at that time. (estrogen was only 8.1 at that check!) My new doc increased progesterone dose to 200 mgs in October (no lab check though) and we increased estradiol because my levels were '< 25'.

I have requested new lab order from my hormone doc to check the current progest/estrogen balance. Last night I skipped the progesterone and I already feel 'better' this morning. I may drop down to 100 mgs now or explore another option for uterine protection. What are those options? Thanks for any insight or guidance.

[Lara]

Some women get a negative mood/energy reaction from Prometrium or any type of oral micronized progesterone. Although I wouldn't call it "progesterone dominance." And I generally don't see a need to test blood levels of estrogen and progesterone in the situation of post-menopause hormone therapy. The guiding principle is to use only as much as you need to relieve symptoms and no more.

And yes, you might feel better dropping to a lower 100 mg dose of progesterone or taking progesterone vaginally (which usually doesn't cause the mood side effects), or looking at a hormonal IUD for uterine protection.

But of course, check with your doctor.

[Bethraymond]

Some women get a negative mood/energy reaction from Prometrium or any type of oral micronized progesterone. Although I wouldn't call it "progesterone dominance." And I generally don't see a need to test blood levels of estrogen and progesterone in the situation of post-menopause hormone therapy. The guiding principle is to use only as much as you need to relieve symptoms and no more.

And yes, you might feel better dropping to a lower 100 mg dose of progesterone or taking progesterone vaginally (which usually doesn't cause the mood side effects), or looking at a hormonal IUD for uterine protection.

But of course, check with your doctor.

I just posted this on my “support for women on the iud” and had 2 women recommend your book!

My question is, do I need to find a functional med dr over this DO? He is acknowledging the IUD looks like it’s a huge contributor to my gain, but is CLUELESS when it comes to any supplements. I have been to a holistic that put me on soooo many supplements I literally had so many that if I cupped my hands together (as if I was gathering water out of a stream to drink), they were BRIMMING w/ pills! So I think it can be just as difficult with someone who OVER prescribes supplements. Ugh.

………………..

I’m 54 and up to 159lbs from 128 at insertion in 2019.

I had a dbl pulmonary embolism that put me on blood thinners. My periods became like murder scenes in my pants! I was desperate and got the IUD after being on the pill for like 25yrs. Can’t be on the pill anymore, ‘cause PE.

My previous drs swear it doesn’t cause weight gain!

I switched drs.

My new DO Dr (who I swear is like 18!) looked at my little line chart and said, “It’s gotta be the IUD!” Going to a new gyno in Aug that specializes in peri and menopause. Before that appt, I wanted a full blood work up to make sure there wasn’t something else blatingly obvious for this weight gain. The DO ordered them all, checking all the usual weight gain suspects. All are normal.

He suggested removing it for 3 mon and see what happens. I’ll be able to show the new gyno the blood work and hopefully she’ll see the light.

My only worry is, at my age, it’s harder to lose weight. If she takes it out and I stay at this weight I will lose my mind ladies!!!